The proposed project is a six year, prospective study on the fetal alcohol syndrome. The overall goals of the study are to determine the incidence of fetal abnormalities secondary to excessive alcohol consumption, and to examine the efficacy of intensive alcoholism treatment in reducing the frequency of fetal anomaly. Four phases are proposed. The first is a Discovery and Screening Phase (2 years) using the Michigan Alcoholism Screening Test (MAST) as part of the high risk screening conducted by the prenatal clinic at Cleveland Metropolitan General Hospital (CMGH). During this period, pregnant women scoring positively and negatively on the test will be identified. Concurrently, the Treatment and Prenatal Monitoring Phase (2 years 9 months) will consist of randomly assigning positive MAST responders to high intensity and low intensity treatment and an equal number of negative responders to a non-alcoholic comparison group. In the low intensity group, routine prenatal monitoring and Alcoholics Anonymous are the only treatment modalities to be employed. In the high intensity treatment group, identified women will be enrolled in an intensive abstinence-oriented treatment program consisting of individual counselling, specialized group counselling and referred to Alcoholics Anonymous. Fetal outcome will be assessed in the low-intensity treatment group, the high intensity treatment group, and the non-alcoholic comparison group. Subgrouping will determine the results for individuals who accept or reject treatment. The prenatal monitoring will consist of monthly evaluations of volume and pattern of alcohol intake using the Volume Pattern Index; social, physical and economic factors using the Data Base Sheet for Alcohol Related Problems; monthly dietary assessment, monthly blood alcohol levels and routine prenatal monitoring as part of the antenatal clinic visit to CMGH through parturition. The Postnatal Outcome Analysis Phase (3 years) will involve physical, neurological and psychological examination of all study infants (alcohols and controls) to be done at birth, and ages 6 months, 1 year, 2 years, and 3 years. The Statistical Analysis Phase (9 months) will be major analysis on the data collected during the first three phases of the study. Quarterly reporting will occur throughout the six years of the study.